
<%@include file="/WebPages/Includes/header.jsp"%>
<%@include file="/WebPages/Includes/startBody.jsp"%>
<%@include file="/WebPages/Includes/tablesorter.jsp"%>
<%@include file="/WebPages/Includes/navbar.jsp"%>
<%@include file="/WebPages/Includes/startMainContent.jsp"%>
<%@include file="/WebPages/Includes/leftSidebar.jsp"%>

<div class="col-lg-8 col-md-8 col-xs-12 col-sm-9">
	<hr>


 
	<form id="getDetailsForm" method="post">
<h1><strong>Personal Details</strong></h1>
	<input type="hidden" id="id" value="<%=request.getParameter("id")%>" name="id" />
	<input type="hidden" id="type" value="<%=request.getParameter("type")%>" name="type" />
	 
		<div class="form-group">
			<label class="control-label" for="admAddress">Address</label> <input
				class="form-control" id="admAddress" name="admAddress"
				placeholder="Address" type="text" />
		</div>
		<div class="form-group">
			<label class="control-label" for="admCity">City</label> <input
				class="form-control" id="admCity" name="admCity"
				placeholder="City" type="text" />
		</div>

		<div class="form-group">
			<label class="control-label" for="admState">State</label> <input
				class="form-control" id="admState" name="admState" placeholder="State"
				type="text" />
		</div>
		<div class="form-group">
			<label class="control-label" for="admCountry">Country</label> <input
				class="form-control" id="admCountry" name="admCountry"
				placeholder="Country" type="text" />
		</div>
		<div class="form-group">
			<label class="control-label" for="admPin">PIN Code</label> <input
				class="form-control" id="admPin" name="admPin" placeholder="PIN Code"
				type="text" />
		</div>
 
 		<div class="form-group">
			<label class="control-label" for="aaSecurityQ1">Password</label> <input
				class="form-control" id="aaPassword" name="aaPassword"
				placeholder="Password" type="text" />
		</div>
		<div class="form-group">
			<label class="control-label" for="aaSecurityQ1">Confirm Password</label> <input
				class="form-control" id="aaPqassword" name="aaPqassword"
				placeholder="Confirm Password" type="text" />
		</div>
		
		<div class="form-group">
			<label class="control-label" for="aaSecurityQ1">Security Question 1</label> <input
				class="form-control" id="aaSecurityQ1" name="aaSecurityQ1"
				placeholder="Security Question 1" type="text" />
		</div>
		<div class="form-group">
			<label class="control-label" for="aaSecurityA1">Security Answer 1</label> <input
				class="form-control" id="aaSecurityA1" name="aaSecurityA1"
				placeholder="Security Answer 1" type="text" />
		</div>
		<div class="form-group">
			<label class="control-label" for="aaSecurityQ2">Security Question 2</label> <input
				class="form-control" id="aaSecurityQ2" name="aaSecurityQ2"
				placeholder="Security Question 2" type="text" />
		</div>
		<div class="form-group">
			<label class="control-label" for="aaSecurityA2">Security Answer 2</label> <input
				class="form-control" id="aaSecurityA2" name="aaSecurityA2"
				placeholder="Security Answer 2" type="text" />
		</div>
		 
		<button class="btn btn-primary" id="submit" type="button">Request</button>
	</form>






</div>

<%@include file="/WebPages/Includes/rightSidebar.jsp"%>
<%@include file="/WebPages/Includes/endMainContent.jsp"%>
<%@include file="/WebPages/Includes/footer.jsp"%>

<!-- custom scripts here -->
<script src="/easyskool/customJS/Login/Request/getDetails.js"></script>

<%@include file="/WebPages/Includes/endBody.jsp"%>